Interest Form for Participation in Research Activities in the Cooperation Lab at Boston College

Sign Up for a Collaborative Study with Queen's University Belfast and Boston College

Thank you for your interest in our research activities! Upon completing this form, Boston College researchers will contact you to arrange an appointment if your child meets the eligibility criteria for a study. If you are interested in participating, please fill out the information below.

Parent Information

Parent First Name

Parent Last Name

Email Address

Phone Number

Current Time Zone

During which times are you and your children most often available to participate? (Please select all that apply and respond according to the time zone indicated above)

Weekday mornings (8am-12pm)
Weekday afternoons (12pm-5pm)
Weekday evenings (after 5pm)
Weekend mornings (8am-12pm)
Weekend afternoons (12pm-5pm)
Weekend evenings (after 5pm)

Any comments on your availability provided above?

Child Information

Name

First Child's Date of BirthChild's Date of Birth (Please write out the full birthday. For example, January 1, 2017)

Gender

Languages Heard By Child (Please list languages and percentages heard.)

Which of the following best represents your child's nationality?

I'd like to add another child

Child 2 Information

Second Child's Name

Second Child's Date of Birth (Please write out the full birthday. For example, January 1, 2017)

Gender

Languages Heard By Child (Please list languages and percentages heard.)

Which of the following best represents your child's nationality?

I'd like to add another child

Child 3 Information

Third Child's Name

Third Child's Date of Birth (Please write out the full birthday. For example, January 1, 2017)

Gender

Languages Heard By Child (Please list languages and percentages heard.)

Which of the following best represents your child's nationality?

I'd like to add another child

Child 4 Information

Fourth Child's Name

Fourth Child's Date of Birth (Please write out the full birthday. For example, January 1, 2017)

Gender

Languages Heard By Child (Please list languages and percentages heard.)

Which of the following best represents your child's nationality?

How did you hear about us? If you heard about us through Children Helping Science, which research activity are you interested in?

Do you live in the Greater Belfast area?

No
Yes

Are you interested in having your child participate in future research? If you mark "yes," you will be added to a database maintained by researchers at Queen's University Belfast, and they may contact you about participating in future online or in person research studies.

No
Yes